Policy Forms

    BI-WEEKLY PAYROLL FORMS 

HRN WEEKLY MILEAGE LOG FORM: (Blank Form PDF)
Submit bi-weekly with your Weekly Documentation Timesheets for mileage reimbursement.  Submit mileage from "Monthly Activity Form" on your weekly Mileage Logs. Mileage is processed by dates, not by Participants.  Multiple participants will be included on each log, starting Sunday's date and ending Saturday's date.

MILEAGE  INSTRUCTIONS (PDF)

HRN MONTHLY ACTIVITY FORM: (Blank Form PDF)
This HRN form is for Peer Supporters to submit reimbursement &/or compensation for various activities outside of individual Peer Support and Mileage. This can be submitted bi-weekly or monthly if preferred.

ACTIVITY FORM INSTRUCTIONS (PDF)

HRN WEEKLY DOCUMENTATION TIMESHEET: (Blank Form PDF)
Time submitted on this form will be reviewed by the HRN supervisor before being sent to various agencies to be processed.  Please complete the information of each area as follows: 

DOCUMENTATION INSTRUCTIONS (PDF)
CLIENT NAME: Any time will be processed directly to this person and must be spent directly with them;
COUNTY:  Participant’s primary residence and is used to process billing;
DIAGNOSIS: Choose ‘MH’ for mental health, ‘AoD’ alcohol & other drugs, or ‘Both’ for co-occurring;
REFERRING AGENCY: Circle or type "Firelands/Bayshore/Member/Other" (If you are unsure of the correct answer please clarify with the HRN supervisor before submitting to ensure proper processing.)
SIGNATURE & DATE: When typing/signing, you attest the information is true/accurate to your knowledge on that date.  Please double check all of the fields are correct before submitting.
NARRATIVE SUMMARY OF CONTACTS THIS WEEK: This section is an on-going skill and will be addressed in monthly supervision. Generally speaking, avoid too little and avoid too much.
-Beginning Tips:  Use 'SOAP' (Subjective, Objective, Action, Plan, click for more)
& 'WRAP' https://www.wellnessrecoveryactionplan.com/what-is-wrap/

   HUMAN RESOURCE FORMS 

HRN Safety & Mandated Reporting Contract
Each HRN Peer Supporter must sign and follow these guidelines in their work.

HRN Professional & Ethical Contract
Each HRN Peer Supporter must sign and follow these guidelines in their work.

HRN Wellness & Safety Policy

HRN Employment Verification Form

HRN Substance Misuse Policy

HRN Wellness Self-Evaluation Form

HRN Supervision Policy

HRN PRSS Performance Evaluation Form

HRN PRSS Performance Improvement Plan

  OTHER PRSS FORMS 

HRN PRSS Participant Caseload List
Blank form that can be printed and submitted to help with Time-Off Requests, or evaluating caseload in general.

   PRSS HIRING FORMS 

I-9 Verification Form
Part of the hiring process along with other paperwork and background checks.

HRN PRSS Hiring Form